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Addressing Health Barriers to Understand Health Disparities

Addressing Health Barriers to Understand Health Disparities. Renita Woolford National Hunger Fellow. Objectives. Consider race/ethnicity, SES, and gender simultaneously. Discuss economic, social, and environmental barriers to optimal health.

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Addressing Health Barriers to Understand Health Disparities

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  1. Addressing Health Barriers to Understand Health Disparities Renita Woolford National Hunger Fellow

  2. Objectives • Consider race/ethnicity, SES, and gender simultaneously. • Discuss economic, social, and environmental barriers to optimal health. • Explore the correlation between these health barriers and unequal distributions of disease. • Look at Coronary Heart Disease as one example of health disparities among racial, SES, and gender lines.

  3. Intersectional Approach to Understanding Health Barriers HEALTH BARRIERS CONSEQUENCES OF BARRIERS CHD RISK Race/ Ethnicity SES Gender Economic Hypertension Obesity Diabetes Poor Nutrition Social Environmental Physical Inactivity

  4. Barriers to optimal health

  5. Economic Barriers • Income and Education • HS dropout: $14,202 • HS grad: $21,219 • College grad: $38,628 • Federal Poverty Line • Family of 4: $22,050 • Single adult under 65: $10,830

  6. Economic Barriers • Thrifty Food Plan • National standard for nutritious diet at minimal cost • $34.60/week • $149.80/month • SNAP (food stamps) • Net income must be 100% below poverty • Gross income 130% below poverty • Countable resources less than $2,000 • Personal vehicle worth less than $4,650 Single woman between 19 and 50 yrs of age

  7. Economic Barriers: Consequences • Choose less expensive foods that are high in fat and calories • Skip meals periodically or forfeit their own meal to feed their children. • Poor nutrition  diet-induced conditions

  8. Social Barriers • Institutionalized Discrimination • Residential segregation • Lack of social cohesion among neighbors • Lack of community expectations • Community reputation within and outside neighborhood

  9. Social Barriers • Food Insecurity • Food deserts- lack of food variety and freshness among community • High Cost for Healthy Foods • Fruits and Vegetables • Monopolized grocery stores • Corner stores, fast food, and liquor stores • Predominantly found in low-income neighborhoods • SNAP & EBT • Not accepted everywhere • Stigmatization

  10. Social Barriers: consequences • Lack of access to adequate nutritious meals • Selection of unhealthy food choices because lower cost • No expectations for healthy behavior • Poor nutrition  increased health problems

  11. Environmental Barriers • Community Space Usage • Poorly maintained housing • Inadequate/non-existent recreational facilities • Neighborhood cleanliness • Neighborhood Safety • Crime and illegal activity • Drugs, prostitution, gang activity • Damaged and unsafe outdoor areas • Cracked sidewalks, vacant buildings • Community trust and cohesion

  12. Environmental Barriers: Consequences • Physical Inactivity • No available space for play and exercise • Mistrust of community members • Fear of safety due to crime • Filthy available areas

  13. Intersectional Approach to Understanding Health Barriers HEALTH BARRIERS CONSEQUENCES OF BARRIERS CHD RISK Race/ Ethnicity SES Gender Economic Hypertension Obesity Diabetes Poor Nutrition Social Environmental Physical Inactivity

  14. Coronary Heart Disease (CHD) • Most common heart type of heart condition in US • Leading cause of death among African Americans • Occurs due to hardening & narrowing of coronary arteries when plaque builds up on walls

  15. Coronary Heart Disease (CHD) • Major Risk Factors • High blood cholesterol • Hypertension • Obesity • Diabetes Mellitus • Physical Inactivity • Tobacco Usage • Increase Age • Gender • Heredity

  16. Poor Nutrition & CHD Risk Factors Obesity Hypertension • Unbalanced caloric intake • Food high in saturated & trans fat • High in cholesterol • Increased intake of alcohol • Overweight/obese  hypertension • High levels of blood fats • High fat & sodium intake • High LDL cholesterol

  17. Physical Inactivity & CHD Risk Factors Physical Inactivity • 2x more likely to develop CHD • Linked to hypertension, diabetes, & obesity • Women & African Americans found to be less physically active then men

  18. Summary • Economic, social, and environmental barriers can influence health outcomes • Important to acknowledge race/ ethnicity, SES, and gender individually and simultaneously • Low-income African American women are at a great risk for experiencing health problems

  19. Policy Recommendations • Increase SNAP eligibility restrictions • Provide scholarships for SNAP participants who want to attend college • Provide economical incentives for food industry businesses • Research that tracks health status of SNAP recipients • All Farmers’ Markets provided with appropriated equipment and TA • Funding for recreational facilities • SNAP outreach coupled with health education • Research that determines realistic monthly allotment.

  20. Thank You!!http://www.witnessestohunger.org/RenitaWoolfordrenita.woolford@alumni.duke.edu

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